• Kris French, Kent Sanders, Steve S Chin, and Mark Bromberg.
• Department of Neurology, University of Utah Hospitals and Clinics, 175 North Medical Drive East, Salt Lake City, Utah 84132, USA. kris.french@hsc.utah.edu
• Muscle Nerve. 2012 Jul 1; 46 (1): 129-33.

IntroductionSymptomatic venous malformation (VM) of muscle in adults is rare and usually presents in childhood or adolescence as the individual is growing. We describe an atypical presentation of a malformation affecting the gastrocnemius muscle asymmetrically with onset in adulthood, which created a diagnostic challenge. Electromyography (EMG) and muscle biopsy did not fit clinically and MRI of the gastrocnemius led to the diagnosis.MethodsThe setting for the patient studied was a neuromuscular outpatient clinic.ResultsEMG showed decreased insertional activity and motor unit potential recruitment in the right gastrocnemius muscle. Muscle biopsy showed mild neurogenic changes. MRI demonstrated VM in the contralateral gastrocnemius muscle.ConclusionsThis case represents a rare cause of atrophic weakness in adults, but muscle MRI should be considered when other tests are equivocal.Copyright © 2012 Wiley Periodicals, Inc.

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